How much rates vary
Facilitymedian $6,761 · 10th to 90th $977 to $22,909Professionalmedian $1,479 · 10th to 90th $851 to $2,291
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $4,365.16 Median $6,606.93 Typical High $8,709.64 | Facility | None | $4,365.16 | $6,606.93 | $8,709.64 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,380.38 Typical High $1,380.38 | Professional | None | $933.25 | $1,380.38 | $1,380.38 |
Anthem BCBS Setting Facility Modifier None Typical Low $1,174.90 Median $22,908.68 Typical High $28,183.83 | Facility | None | $1,174.90 | $22,908.68 | $28,183.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $851.14 Median $1,621.81 Typical High $2,187.76 | Professional | None | $851.14 | $1,621.81 | $2,187.76 |
Anthem BCBS Setting Professional Modifier 50 · Both sides Typical Low $1,288.25 Median $2,398.83 Typical High $3,311.31 | Professional | 50 · Both sides | $1,288.25 | $2,398.83 | $3,311.31 |
Anthem BCBS Setting Professional Modifier 80 · Assistant surgeon Typical Low $134.90 Median $257.04 Typical High $354.81 | Professional | 80 · Assistant surgeon | $134.90 | $257.04 | $354.81 |
Anthem BCBS Setting Professional Modifier AS · PA/NP assist Typical Low $120.23 Median $223.87 Typical High $309.03 | Professional | AS · PA/NP assist | $120.23 | $223.87 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $851.14 Median $13,803.84 Typical High $17,378.01 | Facility | None | $851.14 | $13,803.84 | $17,378.01 |
Cigna Setting Professional Modifier None Typical Low $1,445.44 Median $1,698.24 Typical High $2,187.76 | Professional | None | $1,445.44 | $1,698.24 | $2,187.76 |
ConnectiCare Setting Facility Modifier None Typical Low $512.86 Median $676.08 Typical High $831.76 | Facility | None | $512.86 | $676.08 | $831.76 |
ConnectiCare Setting Professional Modifier None Typical Low $1,023.29 Median $1,348.96 Typical High $1,778.28 | Professional | None | $1,023.29 | $1,348.96 | $1,778.28 |
United Setting Facility Modifier None Typical Low $1,000.00 Median $6,165.95 Typical High $11,481.54 | Facility | None | $1,000.00 | $6,165.95 | $11,481.54 |
United Setting Professional Modifier None Typical Low $707.95 Median $1,412.54 Typical High $2,454.71 | Professional | None | $707.95 | $1,412.54 | $2,454.71 |
6 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $467.74 Median $691.83 Typical High $691.83 | Professional | 52 · Reduced service | $467.74 | $691.83 | $691.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $186.21 Median $275.42 Typical High $275.42 | Professional | 53 · Discontinued | $186.21 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $707.95 Median $1,023.29 Typical High $1,023.29 | Professional | 54 · Surgery only | $707.95 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $141.25 Median $204.17 Typical High $204.17 | Professional | 55 · Aftercare only | $141.25 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $93.33 Median $138.04 Typical High $138.04 | Professional | 56 · Pre-op care only | $93.33 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $660.69 Median $954.99 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $660.69 | $954.99 | $954.99 |
Where Connecticut sits
The same service costs 7.9 times more in Alaska than in Texas. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Connecticut· 12th of 51
$1,622
AK $3,715TX $468
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.